<p>Risk Factors for Lymph Node Metastasis and Survival Outcomes in Colorectal Neuroendocrine Tumors</p>

Abstract

The aim of our study was to analyze the factors affecting lymph node metastasis (LNM) and the prognosis of colorectal neuroendocrine tumors (NETs). Patients and Methods: A retrospective analysis was conducted to collect the clinical data of 135 patients with colorectal NETs from January 2000 to December 2018, including clinical manifestations, pathological results, treatment methods, etc. Follow-up was regularly performed to observe the recurrence and metastasis of tumors and to identify the clinical and pathological features of colorectal NETs, risk factors for LNM and survival outcomes. Results: Among 135 patients, there were 57 (42.2) patients with LNM, and the independent risk factors for LNM in the multivariable analyses were tumor diameter ≥2 cm (P= 0.040) and tumor grade G3 (P=0.001). Patients were followed up for 1 to 190 months, and of the 133 patients who were successfully followed up, the 5-year OS was 71.7%, and the 5-year PFS was 69.0%. The multivariate analysis for survival outcomes showed that age ≥65 years (P=0.002/<0.001) and lymph node metastasis (P=0.018/0.025) were independent risk factors affecting 5-year PFS and OS in colorectal neuroendocrine tumors. Tumors in the colon (P=0.022), moderately positive (++) CgA (P=0.010) and strongly positive (+++) CgA (P=0.007) were independent risk factors for poor 5-year PFS in patients with colorectal NETs. Conclusion: Rectal NETs have a better prognosis than colonic neuroendocrine tumors. Tumor diameter and tumor grade are independent risk factors for LNM in colorectal neuroendocrine tumors. Age, tumor location, lymph node status and a positive level of the neuroendocrine marker CgA are independent risk factors that affect the prognosis of colorectal NETs.

Combined Detection of Free Fatty Acid (FFA) and High-Density Lipoprotein Cholesterol (HDL-C) is a Promising Pretreatment Biomarker for Predicting the Overall Prognosis (OS) of Neuroendocrine Tumours (NETs) in the Colorectum: A Case-Control Study.

“…The risk of metastases is verylow (<3%) in rectal NETs< 10 mm and very high (30%-80%) in rectal NETs ≥ 20 mm in size, while betweenthese two extremes, 4%-20% of patients with rectal NETs measuring 10-19 mm have synchronous or metachronous metastases(de Mestier et al 2019). In addition, tumour size and lymph node metastasis have also been shown to be predictors of poor prognosis in colorectal NETs(Fields et al 2019;Sohn et al 2017;Wu et al 2020), consistent with our study.Traditionally, the level of FFA has been detected to assess lipid metabolism and has been associated with hypertension, cardiovascular disease, type 2 diabetes, and obesity(Ghosh et al 2017). Similarly, HDL-C, LDL-C, TG, CHOL, ApoA1) and ApoB, all widely used, were analysed to assesslipid metabolismin the body as combined biochemical indicators.…”

Risk factors for lymph node metastasis in rectal neuroendocrine tumors: A recursive partitioning analysis based on multicenter data

“…Many studies have shown that factors such as tumor size, World Health Organization (WHO) grade, and depth of invasion may be closely related to LNM. [5][6][7][8] However, most of these studies were based on single-center data and reported highly heterogeneous results. Moreover, most of these studies included patients with all types of rectal neuroendocrine neoplasms, and there are few studies on the predictors of LNM in well-differentiated RNETs.…”

Risk factors for lymph node metastasis and prognosis in colorectal neuroendocrine tumours

“…Kim et al work suggested that CgA expression was an independent predictor of prognosis [ 27 ]. Wu et al study confirmed that age, tumour location, lymph node status and positive level of CgA were independent risk factors affecting prognosis [ 16 ]. Therefore, the prognosis of colorectal neuroendocrine tumour cannot be determined by any one factor and needs to be considered comprehensively, especially the poor prognosis with advanced age and distant metastasis.…”

“…Therefore, the study of lymph node metastasis and its related factors is of great significance for clinical diagnosis and treatment [14]. Studies have shown that there is a close relationship between tumour size and the risk of metastasis [10,[15][16][17][18][19], but it did not come up with an exact value. In this study, we examined the value of tumour size on the risk for lymph node metastasis and the factors associated with prognosis of CR-NETs.…”